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Dolcanatide is an orally administered, synthetic peptide analog of the human endogenous natriuretic hormone uroguanylin. It acts as a guanylate cyclase C (GC-C) agonist, stimulating GC-C receptors in the gastrointestinal tract to increase cyclic GMP production. This mechanism leads to potential laxative, anti-nociceptive, and anti-inflammatory effects. Dolcanatide was designed with select D-amino acid substitutions for enhanced stability and persistence in the gut lumen compared to natural uroguanylin. It has been investigated primarily for ulcerative colitis, constipation (including opioid-induced constipation), chronic pain associated with gastrointestinal disorders, and colorectal cancer chemoprevention. The drug is minimally absorbed systemically and acts locally within the gut[1][3][4][5][7][8].
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